Where the breast implant is placed can make a big difference in the results of your breast enlargement. Breast implant placement affects not only the appearance of your breasts, but also how they feel, your recovery period, and your likelihood of certain complications. There are three placement options:

Submuscular placement puts the breast implant below the pectoralis muscle of the chest. This is most frequently recommended at the Bougainvillea Clinique.

Dual-plane placement puts the breast implant partially under the muscle.

Like other breast enlargement options there is no single best option for breast implant placement. Which is best for you depends on how you are built and what you are hoping to achieve with your breast enlargement.

Subglandular (Subfascial) Breast Implant Placement

Placing the implant directly under the breast tissue is mostly recommended for women who have thicker tissues, a fairly broad chest, particularly if the breasts do not have a very well defined shape. As the implant is above the muscle, the implants will often sit a little closer together for more cleavage. In very slim women with very thin tissues it is usually preferable to place the implants under the muscle for better coverage of the implant, particularly in the upper part of the breast where implants directly under the skin may be more visible. The only time that subglandular (subfascial) implant placement may be recommended in very slim women is in women body builders and gymnasts where the effect of very strong thick muscle may distort the shape of the implant when placed under the muscle. In these women gel implants are always recommended.

It is very important that your surgeon place the implants under the fascia (subfascial) when performing subglandular (subfascial) augmentation. This is a very thin but often quite strong layer of tissue that covers the muscle and adds extra tissue thickness over the implant. This is particularly important if subglandular (subfascial) implants are to be placed through the armpit or transaxillary incision. In thinner patients, another way to improve the thickness of the tissues over the implants is to us fat micrografting under the skin, otherwise known as composite breast augmentation. This can be very useful to hide rippling, create more cleavage, and in some cases treat mild capsular contracture or hardening.

If you do not have very much breast tissue, subglandular (subfascial) placement can make the implants more visible, so it is often best to choose gel implants for over the muscle in slimmer patients as the implants will be less visible and have less likelihood of visible of rippling. Gel implants are also good for subglandular (subfascial) placement because they reduce the incidence of sagging by putting less stress on the skin and breast tissue. On the other hand, implants placed above the muscle may be more likely to experience capsular contracture, in which the capsule around the breast implants gets firm and contracts. In severe cases capsular contracture can make the breasts feel hard, distort their shape, and can even be painful.

Submuscular Breast Implant Placement

Submuscular placement allows more tissue padding over the breast implant. This is usually the best option for slimmer women with very thin tissues and little breast tissue of their own. Because it dramatically reduces the incidence of capsular contracture, there are many surgeons who insist this is the best option, but it does have disadvantages.

Women with well-developed upper body muscles may find that their muscles compress or displace the implant. If the breasts tend to sag, implants placed below the muscle may not sit directly behind the breast, creating an appearance of dual breasts, sometimes termed a "double-bubble" appearance. For these women subglandular (subfascial) or dual-plane placement may be recommended.

Dual Plane Breast Implant Placement

In dual plane placement, the top of the breast implant sits below the muscle, while the bottom of the implant rests below the breast tissue. This remedies the problem of submuscular implants sitting too high, but also allows the top of the implant to be covered by the muscles so it is less visible. This implant placement is recommended for women with slightly sagging breasts, and especially those who are having a breast lift combined with their breast enlargement.

**Complimentary consultations are offered only for cosmetic surgery and other purely cosmetic procedures, and does not apply to reconstructive procedures, insurance based procedures, or consultations for second opinions and legal evaluation.

* Individual results may vary.

Disclaimer: The information throughout the Bougainvillea Clinique of Winter Park, Fl website is not intended to be taken as Cosmetic Surgery advice. The information throughout this cosmetic surgery web site is intended to provide general information regarding plastic surgery in Florida. All photos courtesy of Dr. Hartog, all rights reserved. If you are interested in plastic surgery procedures such as breast augmentation and breast enhancement in the Central Florida area including Winter Park, and Orlando, FL area, contact Florida Plastic Surgeon, Dr. Jeffrey Hartog, M.D. today.* Individual results may vary.